Provider Demographics
NPI:1962116798
Name:PARAISO, VICTORIA (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:PARAISO
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11751 ALTA VISTA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6442
Mailing Address - Country:US
Mailing Address - Phone:817-562-1006
Mailing Address - Fax:817-562-1009
Practice Address - Street 1:11751 ALTA VISTA RD STE 201
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6442
Practice Address - Country:US
Practice Address - Phone:817-562-1006
Practice Address - Fax:817-562-1009
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist